Autonomy Flashcards
What is autonomy?
Being free to make one’s own life choices
What is an instrumental value?
To be able to make the right decision
What is an intrinsic value?
To be true to yourself
What does respecting autonomy mean?
Enabling autonomous choices: A reasonable range of choices No undue pressure or coercion Adequate information Clear explanation Time to consider options Being non-judgemental
What is paternalism?
Overriding or undermining an individual’s autonomy based on the belief that to do so is in their best interests e.g. withholding bad news or playing down side effects of a treatment
What are some of the arguments used to justify paternalistic dishonesty?
Technical information is difficult to put across – patients may not understand or may put undue weight on rare complications of treatment
Doctors face uncertainty – life expectancy or outcome of a treatment may be unpredictable
The patient might not be able to handle the information – might make him worse ‘what you don’t know can’t hurt you’
What are the consequences of withholding information?
Many patients with a serious illness suspect their diagnosis. Uncertainty causes anxiety
Patients may not trust their doctor if they feel she/he is not being honest with them
Why is there a duty to respect autonomy?
Knowing the diagnosis and prognosis is important for making other important decisions
Most patients want to be told their diagnosis
What are the arguments that lying is worse than withholding the truth?
Withholding info restricts autonomy less Patients may actively ‘collude’ in the withholding of information Impossible to tell patients everything Less likely to cause mistrust Absolute moral duty not to lie
What are the arguments that lying is better than withholding the truth?
If intention is the same then morally equivalent
Wrong to assume patients don’t want to know
Will cause equal mistrust
Moral duty not to withhold info that you know would be important to patient
How does respecting autonomy influence outcomes in medicine?
likely improves them
What is respecting autonomy inherently linked to?
truthfulness
